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I have always taken the responsibility of being an educator very seriously. To provide someone advice and direction should never be taken lightly. It is a great honor and privilege to be an educator. Having someone trust that you have their best interest in mind at all times can only be earned. Watching a young person grow, develop, and achieve their dreams is something very special to experience. To have a tiny part in that process is beyond gratifying. This book is dedicated to the several hundred young dentists that have placed their trust in me during my lifetime. I am blessed and eternally grateful

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Dr Larkin is a native of Omaha Nebraska and is a graduate of the Creighton University School of Dentistry.

In October of his senior year, Dr Larkin leased a space, designed an office, and obtained a construction/equipment loan. On subsequent weekends, he and his roommates remodeled the space. Shortly before graduation he received an offer to join a prominent practice in another state. He sold his newly built office to a fellow classmate. When most senior students were preoccupied with passing their national board exams, Dr Larkin had already built and sold his first office. He has built several practices in his 17 years of private practice and his practices have consistently been in the top 5% of profitability percentages nationwide.

In 1995 he began to teach part time at the Creighton School of Dentistry. He authored a practice management handbook for a lunch and learn series that he gave, “Starting and Building a Dental Practice in the 21st Century. He received the outstanding teacher award in his first year of teaching. The first and only time a part time instructor had received that award.

In 1997 he assisted in developing specialized financial and management services for dental clientele of one of the leading healthcare accounting firms in the Midwest.

In 1998 He developed and eventually sold the first dental e-commerce web sites on the Internet, Dentalauction.com. At the same time he completed the first web development and ecommerce programs at the University of Nebraska. Since then he was taught and been involved in practice management and Internet marketing consulting.

In 2009 he moved to Lexington Kentucky to become an assistant Professor at the University of Kentucky College of Dentistry. He developed a practice management series entitle “The Business of Dentistry, A Mini MBA

He is currently working in dental practice management consulting, implementing his “Flying Start” program and creating the ongoing education series “The Young Dentist Symposium”. He has begun an outline for his next book “The Future of Dentistry….by design”, and is creating an oral wellness web portal and first of its kind app which should be launched in late 2014.

His relocation to Lexington fulfills a life long dream to be located at the center of the horse world. His hobbies include thoroughbred racing, home improvements ,and running his boutique Bed and Breakfast. His daughter is a Centre College graduate and lives in Louisville

I doubt I’ll ever go back to corporate work. Once you see the light, there is no turning back.”

Magnus Jepson, Woo Themes

On your very first day of dental school, I pose a very simple question. How many of you chose dentistry as a profession for the opportunities it gives you to be an independent, self employed, make your own decisions, captain of your own ship kind of individual. The vast majority of students will always raise their hands. Fast forward 4 years and it is graduation. Lets revisit that same question and see how many individuals feel as if they are on that path. Only a smattering of hands go up. What happened in the preceding 4 years. Many things….

Dental education is at a true pivot point historically in my view. Dental schools are pricing themselves into the stratosphere. There is a tremendous shortage of qualified faculty because these jobs are not valued properly. Schools are struggling to keep up with the marketplace technological changes and student loan interest rates are a disgrace. Most distressing, private equity money from Wall Street is pouring into the marketplace by the hundreds of millions to capitalize on a golden moment. To give you a JOB and take away your CAREER.

A combination of the poor business preparation of nearly all dental school graduates and the staggering debt loads that the average graduate carries is preventing new graduates from taking the additional risk of becoming what I call the Dental Entrepreneur.

Since my first short stint as a dental school professor in the mid 90’s to my last five years, which included the creation of what I call a mini MBA in a practice management, I have always had a passion for assisting young dentists. More specifically helping young dentists achieve independence, because deep in my heart, I believe that is what you signed up for!

“Your work is going to fill a large part of your life and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do.”

Steve Jobs

The decision to open one’s own dental practice can be both an exhilarating experience and one of sheer terror. The objective of this e-book is to guide you thru the myriad of decisions that have to be addressed and give practical suggestions to many of the problems that may arise.

One of the things that will dawn on you in a hurry when you begin this endeavor is that you must wear many hats to accomplish this dream.

Solo practice or even participation in a group practice has always been about wearing many hats. It may be that of doctor, accountant, purchaser, psychologist, plumber, and on and on. The process of setting up a dental practice will require you to obtain a variety of skills if you intend to do this in an economical fashion. If you intend to hire experts to make every single decision for you, you will quickly find yourself involved in a project that you probably cannot afford at an early stage of your career.

The incredible financial burden that students face today, combined with the fact that dental schools continue to give minimal attention to the business side of dentistry make the new graduates entry into the marketplace very challenging. Many students today are having to delay their becoming dental entrepreneurs by taking associateships, residencies, and other employment positions that give them the time to collect their thoughts, get experience ,improve clinical speed, and arrange finances. This is in stark contrast to 25 years ago when most graduates began “scratch starts” right out of school. It is only by becoming a dental entrepreneur that you can in my opinion achieve the income levels commensurate with the risk and effort that you put into becoming a dentist. I hate seeing a young person bounce around the first 5 to 10 years of their career because of their inability to get good guidance. That is a tremendous amount of time making average pay when you have invested so much both financially and emotionally for this opportunity. A properly structured and disciplined career should begin to yield financial independence by at least year 15 but that is unfortunately far from the norm today.

I hear Mark Cuban use the word ”Wantrepreneur” quite often in the popular TV show Shark Tank. I think it is a worthy observation. Knowing the clear distinctions between the two mindsets is a valid starting point. Everyone is not cut out to be an entrepreneur. That is neither good nor bad. It is simply a fact. I have no problem at all with an individual being an employee their entire life. As long as it is your choice and you are not in an abusive or compromised position. The majority of the employment situations I see young people settle for today have some degree of these components in them. That is the entire premise for me spending the hundreds of hours developing this material. I want this to be your choice.

The starting point ion any book on entrepreneurship should begin with a self inventory when a person is brutally honest with themselves.

When I started to create the following table, I noticed that there was a culture of certainty in the entrepreneurial mindset. That is why my first two lectures in the “Business of Dentistry” lecture series dealt specifically with mental strategies and goal setting. Just as success in dentistry revolves around people not clinic skills, being an entrepreneurial is really behavioral and not a technical skill. That an interesting observation. That is why the first chapter is,Should I do this?

Wantrepreneur	Entrepreneur
Focused on making money	Laser focused on service
Thinks that people are to be used	Knows that people are to be inspired
No Goals	A carefully crafted life plan
Time wasters	Know that time is the most valuable form of currency
Love meetings	Love results
Fear of failure	Fearless
Make excuses	Make it happen
Think it is about them	Know it is about the team
Want it all right now	Understand delayed gratification
Chronic worriers	Have read and understood Emerson’s “Essay on Compensation”
Procrastinate	Do it now attitude
Look for quick fixes	Life long learners
Defeated by failure	Embrace failure
Think about the future	Act on their future
Feel very uncertain	Deeply believe in their vision
Are play acting	Are the real deal

The decision to start or acquire a dental practice has not only considerable financial ramifications, but also some emotional aspects as well. Opening a practice requires an introspective look at ones goals, aspirations, work ethic, and the most important psychological aspect of being in small business, “confrontational tolerance”. I learned this all important concept from Greg Stanley of Whitehall Management in the early 80’s. It was a game changer for me. Simply put, confrontational tolerance is ones ability to do what most people find uncomfortable and that is; confronting people, situations, and solving problems all day every day. That is why most people are employees and not entrepreneurs/owners. They do not enjoy the constant challenges involved in owning ones own business. The most obvious difference between the owner and employee are the significant financial rewards that can be reaped on the owner/entrepreneur side of this equation. But not everyone is cut out for this.

Anyone in sales can tell you what separates the wheat from the chaff in their line of work is “confrontational tolerance”. To a seasoned salesperson, it is presenting a product over and over until a sale is consummated. Statistically most sales occur after the 7^Th no!. This pretty much describes the perseverance that a professional salesperson has to have in order to succeed.

All of these aspects of confrontational tolerance apply directly to dentistry. Most dentists simply quit the first time a patient says “no” to their recommended treatment and they never mention it to them again. To the dentist going into business for himself, confrontational tolerance is the ability of an individual to risk rejection with every treatment plan presentation, confront unreasonable staff, confront frightened patients, stay on time, stay on budget, make treatment affordable for every patient, stay within OSHA regulations and so on. To the dentist going into business for oneself, in means complete diagnosis and a thorough treatment plan regardless of how many times you have been rejected in the last week.

These are all examples of failing to “confront” what is directly in front of you and will lead to significant problems both financially and emotionally.

Ok, you have passed the confrontational tolerance test and you want to more fully understand what are some of the most important concepts to grasp from day one. How about one that hospitals and physicians totally missed out on until it was too late. Customer Service. The medical profession has for decades treated their customers with almost disdain. Granted there has always been a few family docs that really know how to treat folks but for the most part physicians simply have not cared about the customer experience. And,oh have they paid dearly for that mistake. Now the majority are employees of corporate entities that are now laser focused on customer service and have huge marketing budgets, and guess who pays for that. The salaried physicians who now give their profits to MBA’s and Wall Street. Sound familiar?

Dentists have always been light years ahead of their medical colleagues in emphasizing customer service. Because of the need to make patients comfortable on a daily basis, dentists have become more hard wired to pay attention to peoples feelings and expectations.

Sam Walton coined the phrase “ give them more than they bargained for” to build the largest retail empire in history. It is a fairly simple concept and if you study his success you will quickly come to the conclusion that this was no accident. Sam truly understood and lived by the “Golden Rule”. He put himself in his customers shoes and simply gave them more than anyone else could. Low prices were only part of the equation. Walmart has a very detailed and deliberate approach that I have observed with some fascination. They simply have created a model that is beyond any competition whatsoever. Warren Buffet calls that a “MOAT” around a business. Are those opportunities available in dentistry today. You Bet!

As dentists today become more of a commodity with the growth of corporate dentistry, how do you carve out your piece of the marketplace.?

First, I will tell you emphatically how you can never do it. And that is to compete solely on price, that is a death trap. There are a jillion people in the low cost service provider realm and you will get your head handed to you if you try this. Signing up randomly for every insurance plan without the knowledge of cost and profit is by far the biggest mistake a young dentist can make. I’ve seen more than a few young graduates get into low cost high volume situation and burn out in a matter of months. It is a disastrous scenario that is unfortunately being played out with increased frequency.

People are always concerned about cost but don’t get confused over this vital issue. That is only part of the healthcare dollar decision making process. People rarely shop for the “cheapest” doctor because they understand the potential risks involved.

What they are seeking is value. So lets look at what the healthcare consumer values today.